CDP weighs medical testing in dental office

The Council on Dental Practice will submit a report to the ADA House of Delegates that will include the pros and cons of medical screenings in the dental office.

The research is in response House Resolution 28H-2014, which directed the appropriate ADA agencies to research the implications of incorporating medical screening methods into patient evaluations and report back to the 2015 House. The medical screenings could include tests related to diabetes like hemoglobin A1c or glucose; HPV testing; saliva biomarkers for various cancers; HIV testing; hypertension screening; pre-diabetes screening and blood pressure checks, said Dr. Craig Ratner, chair of the CDP's Subcommittee on Health and Wellness, which is overseeing the council's report to address the House resolution.

"We've met a few times to develop strategies and determine what we could bring back to the council, what the council could bring to the Board and to the House," Dr. Ratner said. "We decided to develop a strict research report and it will be up to the council to determine if the report will contain recommendations to the House."

The subcommittee looked at research from the ADA Health Policy Institute that estimates the health care system could save $102 million each year through dentists incorporating medical screenings into patients' visits.

"There is a segment of the population that sees the dentist more often than a physician or they don't see a physician at all," Dr. Ratner said. "Therefore, if these tests are done in the dental office, you would be identifying some of the patients who wouldn't ordinarily be seen by a physician but should be seen by one. However, the estimated savings is contingent on whether the patient follows up with a physician and is treated."

The subcommittee also identified some barriers that have to be considered when conducting medical screening or testing in the dental office, including liability issues, making sure patients follow through with their medical professionals and regulatory issues. Incorporating medical testing would require additional training of staff. Some states have regulations that exceed federal requirements for conducting medical testing in the office and there are also reimbursement issues to be considered, Dr. Ratner said.

"The reimbursement levels for medical screening tests are low," Dr. Ratner said. "Medical screenings, like blood pressure readings, may have no reimbursement at all. As dentists continue to be seen as oral physicians, the association between oral and systemic health has increased the dentist's role in early identification and referral of patients with potential chronic medical conditions."

CDP members will review the subcommittee's report over the coming months before sending it to the House of Delegates. The House of Delegates meets in November at ADA 2015 in Washington, D.C.